Brain activity related to temporal summation of C-fiber evoked pain

Staud, Roland; Craggs, Jason G.; Robinson, Michael E.; Perlstein, William M.; Price, Donald D.

doi:10.1016/j.pain.2006.10.010

Cited by 194 publications

(179 citation statements)

References 44 publications

(63 reference statements)

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“…Other studies have shown activation in the cerebellum to temporal summation of C-fiber evoked pain, and suggest cerebellar activation may correlate with premotor activity (61,62). In our studies, we observed more widespread activations within the vermis and hemispheres for the patient group and in the nuclei.…”

Section: Pain and The Cerebellumsupporting

confidence: 73%

Human cerebellar responses to brush and heat stimuli in healthy and neuropathic pain subjects

et al. 2008

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Though human pain imaging studies almost always demonstrate activation in the cerebellum, the role of the cerebellum in pain function is not well understood. Here we present results from two studies on the effects of noxious thermal heat and brush applied to the right side of the face in a group of healthy subjects (Group I) and a group of patients with neuropathic pain (Group II) who are more sensitive to both thermal and mechanical stimuli. Statistically significant activations and volumes of activations were defined in the cerebellum. Activated cerebellar structures were identified by colocalization of fMRI activation with the 'MRI Atlas of the Human Cerebellum'. Functional data (obtained using a 3T magnet) were defined in terms of maximum voxels and volume of activation in the cerebellum. Volume maps were then mapped onto two millimeter serial slices taken through the cerebellum in order to identify activation within regions defined by the activation volume. The data indicate that different regions of the cerebellum are involved in acute and chronic pain processing. Heat produces greater contralateral activation compared with brush, while brush resulted in more ipsilateral/bilateral cerebellar activation. Further, innocuous brush stimuli in healthy subjects produced decreased cerebellar activation in lobules concerned with somatosensory processing. The data also suggest a dichotomy of innocuous stimuli/sensorimotor cerebellum activation versus noxious experience/cognitive/limbic cerebellum activation. These results lead us to propose that the cerebellum may modulate the emotional and cognitive experience that distinguishes the perception of pain from the appreciation of innocuous sensory stimulation.

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Section: Pain and The Cerebellumsupporting

confidence: 73%

Human cerebellar responses to brush and heat stimuli in healthy and neuropathic pain subjects

et al. 2008

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“…Pain-A standardized numerical pain scale (NPS) was utilized for rating the magnitude of painful sensations produced by thermal stimulation as described previously [34]. The scale ranged from 0 to 100, in increments of 5, with verbal descriptors at intervals of 10.…”

Section: Ratings Of Experimentalmentioning

confidence: 99%

Cutaneous C-fiber pain abnormalities of fibromyalgia patients are specifically related to temporal summation

Staud

Bovee

Robinson

et al. 2008

Pain

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Temporal summation of "second pain" (TSSP) is considered to be the result of C-fiber-evoked responses of dorsal horn neurons, termed 'windup'. TSSP is dependent on stimulus frequency (≥ 0.33 Hz) and relevant for central sensitization and chronic pain. We have previously shown that compared to normal controls (NC), fibromyalgia (FM) subjects show abnormal TSSP, requiring lower stimulus intensities/frequencies to achieve similar TSSP. However, it is unknown whether abnormal TSSP in FM is influenced by peripheral sensitization of C-fiber nociceptors and/or bias in pain ratings. Thus we evaluated 14 FM subjects and 19 NC with pain threshold tests to selective Cfiber stimulation, 30 sec heat stimuli, and repetitive brief (1.5 sec) heat pulses at 0.33 Hz using a contact heat stimulator (CHEPS). The intensity of heat pulses was varied to achieve maximal TSSP ratings of 45 ± 10 (numerical pain scale 0-100) in both FM and NC groups. We found that NC and FM subjects had similar pain thresholds to C-fiber stimulation and yet FM subjects required lower heat pulse temperatures to generate the same magnitudes of TSSP (p < .05). This combination of findings does not support peripheral sensitization and suggests central TSSP abnormalities in FM subjects. In a second experiment, all aspects of individually adjusted TSSP heat pulses were kept the same except the baseline temperature (BT) between heat pulses was surreptitiously alternated between 35°C and 40°C. These changes of BT resulted in significantly greater TSSP ratings of FM subjects compared to NC subjects, both at 35°C or 40°C, but did not change their response to the first heat pulse of a stimulus train. These findings provide strong support for alterations of central pain sensitivity and not peripheral sensitization or rating bias as responsible for TSSP differences between NC and FM subjects.

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“…These include areas of the brain involved in pain aŠect (ACC, insula, prefrontal cortex, and SMA) and pain modulation (ACC). 35 A previous study has reported that input from the C-ˆbers arrives at the SII and insula 500 ms after stimulation, 28 but processing is believed to be long because pain perception is a higher brain function that involves complicated and associated brain activity. Therefore, we considered that delayed and long-sustained increases in signal aŠect brain activity with real acupuncture stimulation.…”

Section: Discussionmentioning

confidence: 99%

Deconvolution Analyses with Tent Functions Reveal Delayed and Long-sustained Increases of BOLD Signals with Acupuncture Stimulation

Murase

Umeda

Fukunaga

et al. 2013

MRMS

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We used deconvolution analysis to examine temporal changes in brain activity after acupuncture stimulation and assess brain responses without expected reference functions. We also examined temporal changes in brain activity after sham acupuncture (noninsertive) and scrubbing stimulation. We divided 26 healthy right-handed adults into a group of 13 who received real acupuncture with manual manipulation and a group of 13 who received both tactical stimulations. Functional magnetic resonance imaging (fMRI) sequences consisted of four 15-s stimulation blocks (ON) interspersed between one 30-s and four 45-s rest blocks (OFF) for a total scanning time of 270 s. We analyzed data by using Statistical Parametric Mapping 8 (SPM8), MarsBaR, and Analysis of Functional NeuroImages (AFNI) software. For statistical analysis, we used 3dDeconvolve, part of the AFNI package, to extract the impulse response functions (IRFs) of the fMRI signals on a voxel-wise basis, and we tested the time courses of the extracted IRFs for the stimulations. We found stimulus-speciˆc impulse responses of blood oxygen level-dependent (BOLD) signals in various brain regions. We observed signiˆcantly delayed and long-sustained increases of BOLD signals in several brain regions following real acupuncture compared to sham acupuncture and palm scrubbing, which we attribute to peripheral nocireceptors, ‰are responses, and processing of the central nervous system. Acupuncture stimulation induced continued activity that was stronger than activity after the other stimulations.We used tent function deconvolution to process fMRI data for acupuncture stimulation and found delayed increasing and delayed decreasing changes in BOLD signal in the somatosensory areas and areas related to pain perception. Deconvolution analyses with tent functions are expected to be useful in extracting complicated and associated brain activity that is delayed and sustained for a long period after various stimulations.

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Brain activity related to temporal summation of C-fiber evoked pain

Cited by 194 publications

References 44 publications

Human cerebellar responses to brush and heat stimuli in healthy and neuropathic pain subjects

Human cerebellar responses to brush and heat stimuli in healthy and neuropathic pain subjects

Cutaneous C-fiber pain abnormalities of fibromyalgia patients are specifically related to temporal summation

Deconvolution Analyses with Tent Functions Reveal Delayed and Long-sustained Increases of BOLD Signals with Acupuncture Stimulation

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